Some things never change. While foodborne illness prevention seems stagnant, it’s surprising considering the advancements of modern technology and increased food-based regulations. We would expect the numbers to be decreasing, but instead seem to be still ever present. From the plethora of recalls to the outbreaks you see on the news. We are a modern society. How could this still be an issue? This is a more complicated issue than at first glance. This was the subject of the introductory speech from Stephen Ostroff, M.D., FDA Deputy Commissioner for Food and Veterinary Medicine at this year’s Food Safety Consortium, an annual gathering of industry leaders in food safety and quality assurance.

Deputy Commissioner Ostroff seemed to have a few theories on the complicated nature of why foodborne illness seems resistant to change. It has a little bit to do with increased knowledge and a little bit to do with our behavior as a society. We see more cases because we are looking for more cases. We are preventing more cases in some respects, while leaving ourselves more vulnerable in others. Ways of bridging the gap include increased regulations and stepping stones with implementation of each new effective date of the Food Safety Modernization Act (FSMA).

More Cases Being Counted

It seems that awareness of foodborne illness has increased. But why is that? Ostroff explains that we have much better diagnostics to catch foodborne illness instead of attributing illness to a stomach bug. This, along with more technologically linked surveillance systems than we had 20 years ago, or even 10 years ago. The emergence and use of PulseNet helps gather data across public health laboratories nationwide. We have more data. Much more data! Statistics are powerful, but can be misleading when you are looking at trends over time.

“Those improvements in finding the cases may be masking improvements that have occurred,” says Ostroff. He explains that being able to see more data might be masking positive movement in illness prevention. “We are actually doing better,” says Ostroff. “Within the data, there is some good news and some bad news.”

The actual increase in numbers is but half of the information. The dissemination of information is effortless with news and social media at our fingertips. Literally in the pockets and within reach of most people we can see what’s going on. The more people are aware of a foodborne illness in their area, the more likely they are to connect the dots of their “stomach bug” to something bigger and seek medical attention. At that point they are tested and their sample is potentially linked to an outbreak. Thus, adding to the data pool.

Risky Behavior Bumping Up Statistics

Changes in consumer behavior have contributed to the uptick of foodborne illness. Between the globalization of food supply, increased in Americans eating out, food delivery, and synthetic foods (eek!), we are adding additional factors that increase the risk of foodborne illness.

The globalization of the food supply has presented consumers with foods that might be contaminated with pathogens endemic where they are grown but not so much in the states. Americans find themselves exposed to new food trends, some that are toward the higher risk side.

Americans eat out more now than ever before. In fact, one study indicated that almost one-half of every dollar Americans spend on food is spent at restaurants. The same study suggested that eating food prepared at a restaurant has a higher chance of presenting foodborne illness than food prepared at home. We lose a great deal of control over our food when we are not the only ones responsible for the process.

Our food habits have certainly changed. Even how we get our foods. Ostroff added that in just a matter of a few year up to 20% of the food brought into our homes will be delivered. The risks may end up outweighing the benefits with temperature sensitive foods sitting out for who knows how long. Only time will tell if the need for convenience will persist despite additional food safety concerns.

One of the biggest food risks is the upcoming “synthetic foods” movement. We have no idea the long-term effects of these alternative foods. While the idea of synthetic foods like synthetic meat are meant to remove the possibility of foodborne illness by removing the zoonotic feces impact on the product. This is one of the major sources of foodborne illness. But what seems to be too good to be true probably is. Aside from the sci-fi turned soon-to-be-reality test tube meat, fake meat products are filled with artificial and sometimes harmful food additives that can cause additional downline health effects. But that is a topic for another day.

Increased Regulations Combat New Risks

Some aspects of the FSMA had already rolled out and several more coming to term in the next few years. To be exact, six out of the seven foundational rules have not been put into effect. The last rule, the International Adulteration rule is slated for July 2019. While most moves are to reduce the regulatory burden, there has not been much pushback against the FSMA requirements. Ostroff feels “that’s very good news.”

Positive steps in the FSMA include the third-party certification program where organizations must register. This will help organizations become accredited with the FDA. The Voluntary Qualified Importer Program opens this month. This will help track food providers bringing food into the United States. This, along with some minor “fixes” to the FSMA are upcoming in the next few years. These primarily apply to water provisions.

In light of new inspection and regulations, the FDA has seen an uptick in training. So far, more than 50,000 people have been trained on the Preventative Controls for Human Food rule and more than 5,000 have been trained on the animal food rule.

Are We at Break Even?

We are definitely moving in the right direction with an increase in data gathering and diagnostics and important food regulations. As a society we must monitor our own safety and engage in less risky behavior. Or at least not go too crazy. Will foodborne illness ever go away? It is unlikely. But our response and understanding of how we interact with our food and how our food interacts with our environment is a step in the right direction.